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The 1st Annual Awards for Action on HIV/AIDS and Human Rights.

https://arctichealth.org/en/permalink/ahliterature182022
Source
Can HIV AIDS Policy Law Rev. 2002 Dec;7(2-3):1, 20-3
Publication Type
Article
Date
Dec-2002
Author
Thomas Kerr
Thomas Haig
Source
Can HIV AIDS Policy Law Rev. 2002 Dec;7(2-3):1, 20-3
Date
Dec-2002
Language
English
French
Publication Type
Article
Keywords
Awards and Prizes
Canada
HIV Infections
Human Rights
Humans
Physicians
Abstract
The 1st Annual Awards for Action on HIV/AIDS and Human Rights were awarded to the Vancouver Area Network of Drug Users and to Dr. Wan Yanhai, a Chinese physician and activist. The international attention and media coverage of the awards was heightened by the fact that the Chinese government had detained Dr. Wan for disclosing information about unsanitary blood collection practices in Henan province. An international outcry led to Dr. Wan's release on 20 September 2002.
PubMed ID
14719485 View in PubMed
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Access to drug and alcohol treatment among a cohort of street-involved youth.

https://arctichealth.org/en/permalink/ahliterature153685
Source
Drug Alcohol Depend. 2009 Apr 1;101(1-2):1-7
Publication Type
Article
Date
Apr-1-2009
Author
Scott E Hadland
Thomas Kerr
Kathy Li
Julio S Montaner
Evan Wood
Author Affiliation
Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
Source
Drug Alcohol Depend. 2009 Apr 1;101(1-2):1-7
Date
Apr-1-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Alcoholism - rehabilitation
British Columbia
Cohort Studies
Female
Health Behavior
Health Services Accessibility - statistics & numerical data
Homeless Youth - statistics & numerical data
Humans
Logistic Models
Male
Models, Statistical
Risk factors
Socioeconomic Factors
Substance-Related Disorders - rehabilitation
Treatment Outcome
Waiting Lists
Young Adult
Abstract
A number of options for treatment are available to young drug users, but little is known about the youth who actually attempt to access such services. Here we identify characteristics of a cohort of street-involved youth and highlight commonly encountered barriers.
From September 2005 to July 2007, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort of 529 drug users aged 14-26 living in Vancouver, Canada. Participants who attempted to access any addiction services in the 6 months prior to enrollment were compared in univariate analyses and multiple logistic regression modeling of socio-demographic and drug-related factors.
Factors positively associated with attempting to access services included Aboriginal ethnicity (adjusted odds ratio [AOR]=1.66 [1.05-2.62]), high school education (AOR=1.66 [1.09-2.55]), mental illness (AOR=2.25 [1.50-3.38]), non-injection crack use (AOR=2.93 [1.76-4.89]), and spending >$50 on drugs per day (AOR=2.13 [1.41-3.22]). Among those who experienced difficulty-accessing services, the most commonly identified barrier was excessively long waiting lists. In a subgroup analysis comparing those who tried to access services but were unsuccessful to those who were successful, risk factors positively associated with failure included drug bingeing (odds ratio [OR]=2.86 [1.22-6.76]) and homelessness (OR=3.86 [1.11-13.4]).
In light of accumulating evidence that drug use among street youth is associated with risky health-related behaviors, improving access to treatment and other addiction services should remain an important public health priority.
Notes
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PubMed ID
19081203 View in PubMed
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Access to health and social services for IDU: the impact of a medically supervised injection facility.

https://arctichealth.org/en/permalink/ahliterature149722
Source
Drug Alcohol Rev. 2009 Jul;28(4):341-6
Publication Type
Article
Date
Jul-2009
Author
Will Small
Natasha Van Borek
Nadia Fairbairn
Evan Wood
Thomas Kerr
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.
Source
Drug Alcohol Rev. 2009 Jul;28(4):341-6
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
British Columbia
Data Collection
Female
Health Promotion - methods
Health Services Accessibility - statistics & numerical data
Humans
Male
Middle Aged
Needle-Exchange Programs - organization & administration
Patient Acceptance of Health Care
Referral and Consultation - statistics & numerical data
Substance Abuse Treatment Centers - organization & administration
Substance Abuse, Intravenous - psychology
Young Adult
Abstract
Injection drug users (IDU) often experience barriers to conventional health-care services, and consequently might rely on acute and emergency services. This study sought to investigate IDU perspectives regarding the impact of supervised injection facility (SIF) use on access to health-care services.
Semi-structured qualitative interviews were conducted with 50 Vancouver-based IDU participating in the Scientific Evaluation of Supervised Injecting cohort. Audio-recorded interviews elicited IDU perspectives regarding the impact of SIF use on access to health and social services. Interviews were transcribed verbatim and a thematic analysis was conducted.
Fifty IDU, including 21 women, participated in this study. IDU narratives indicate that the SIF serves to facilitate access to health care by providing much-needed care on-site and connects IDU to external services through referrals. Participants' perspectives suggest that the SIF has facilitated increased uptake of health and social services among IDU.
Although challenges related to access to care remain in many settings, SIF have potential to promote health by facilitating enhanced access to health-care and social services through a model of care that is accessible to high-risk IDU.
PubMed ID
19594786 View in PubMed
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Addiction treatment-related employment barriers: the impact of methadone maintenance.

https://arctichealth.org/en/permalink/ahliterature127377
Source
J Subst Abuse Treat. 2012 Oct;43(3):276-84
Publication Type
Article
Date
Oct-2012
Author
Lindsey Richardson
Evan Wood
Julio Montaner
Thomas Kerr
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
Source
J Subst Abuse Treat. 2012 Oct;43(3):276-84
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Cohort Studies
Employment - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Methadone - administration & dosage
Opiate Substitution Treatment - methods
Opioid-Related Disorders - rehabilitation
Prospective Studies
Socioeconomic Factors
Substance Abuse, Intravenous - rehabilitation
Abstract
Employment is commonly upheld as an important outcome of addiction treatment. To explore this attribution, we assessed whether treatment enrollment predicts employment initiation among participants enrolled in a community-recruited Canadian cohort of people who inject drugs (IDU; N = 1,579). Survival analysis initially found no association between addiction treatment enrollment and employment initiation. However, when methadone maintenance therapy (MMT) was separated from other treatment modalities, non-MMT treatment positively predicted employment transitions, whereas MMT was negatively associated with employment initiation. Subanalyses examining transitions into temporary, informal, and under-the-table income generation echo these results. Findings suggest that individual factors impacting employment transitions may systematically apply to MMT clients and that, in this setting, the impact of treatment on employment outcomes is contingent on treatment type and design. Treatment-specific differences underscore the need to expand low-threshold MMT, explore MMT alternatives, and evaluate the impact of treatment design on the social and economic activity of IDU.
Notes
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PubMed ID
22301085 View in PubMed
Less detail

Adherence and plasma HIV RNA response to antiretroviral therapy among HIV-seropositive injection drug users in a Canadian setting.

https://arctichealth.org/en/permalink/ahliterature135422
Source
AIDS Care. 2011 Aug;23(8):980-7
Publication Type
Article
Date
Aug-2011
Author
Seonaid Nolan
M-J Milloy
Ruth Zhang
Thomas Kerr
Robert S Hogg
Julio S G Montaner
Evan Wood
Author Affiliation
BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
Source
AIDS Care. 2011 Aug;23(8):980-7
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active - statistics & numerical data
Canada
Cohort Studies
Drug Users - psychology
Female
HIV Infections - blood - drug therapy - psychology
Humans
Kaplan-Meier Estimate
Male
Medication Adherence
Middle Aged
Patient compliance
Proportional Hazards Models
RNA, Viral - blood - drug effects
Substance Abuse, Intravenous
Treatment Outcome
Young Adult
Abstract
HIV-positive individuals who use injection drugs (IDU) may have lower rates of adherence to highly active antiretroviral therapy (ART). However, previous studies of factors associated with adherence to ART among IDU have been limited primarily to samples drawn from clinical settings and in areas with financial barriers to healthcare.We evaluated patterns of ART adherence and rates of plasma HIV RNA response among a Canadian cohort of community-recruited IDU. Using data from a community-recruited cohort of antiretroviral-naive HIV-infected IDU, we investigated ART adherence patterns based on prescription refill compliance and factors associated with time to plasma HIV-1 RNA suppression (
PubMed ID
21480010 View in PubMed
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An external evaluation of a peer-run outreach-based syringe exchange in Vancouver, Canada.

https://arctichealth.org/en/permalink/ahliterature144535
Source
Int J Drug Policy. 2010 Sep;21(5):418-21
Publication Type
Article
Date
Sep-2010
Author
Kanna Hayashi
Evan Wood
Lee Wiebe
Jiezhi Qi
Thomas Kerr
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada; Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, Canada.
Source
Int J Drug Policy. 2010 Sep;21(5):418-21
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
British Columbia - epidemiology
Drug users
Epidemics
Female
HIV Infections - prevention & control
Humans
Male
Needle Sharing - adverse effects
Needle-Exchange Programs
Peer Group
Program Evaluation
Risk factors
Risk-Taking
Sexual Partners
Substance Abuse, Intravenous
Abstract
Vancouver, Canada has been the site of an epidemic of human immunodeficiency virus (HIV) amongst injection drug users (IDU). In response, the Vancouver Area Network of Drug Users (VANDU) initiated a peer-run outreach-based syringe exchange programme (SEP) called the Alley Patrol. We conducted an external evaluation of this programme, using data obtained from the Vancouver Injection Drug Users Study (VIDUS).
Using generalised estimating equations (GEE) we examined the prevalence and correlates of use of the SEP amongst VIDUS participants followed from 1 December 2000 to 30 November 2003.
Of 854 IDU, 233 (27.3%) participants reported use of the SEP during the study period. In multivariate GEE analyses, service use was positively associated with living in unstable housing (adjusted odds ratio [AOR]=1.83, 95% confidence interval [CI]: 1.39-2.40), daily heroin injection (AOR=1.31, 95% CI: 1.01-1.70), daily cocaine injection (AOR=1.34, 95% CI: 1.03-1.73), injecting in public (AOR=3.07, 95% CI: 2.32-4.06), and negatively associated with needle reuse (AOR=0.65, 95% CI: 0.46-0.92).
The VANDU Alley Patrol SEP succeeded in reaching a group of IDU at heightened risk for adverse health outcomes. Importantly, access to this service was associated with lower levels of needle reuse. This form of peer-based SEP may extend the reach of HIV prevention programmes by contacting IDU traditionally underserved by conventional syringe exchange programmes.
Notes
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PubMed ID
20359877 View in PubMed
Less detail

An external evaluation of a peer-run "unsanctioned" syringe exchange program.

https://arctichealth.org/en/permalink/ahliterature183989
Source
J Urban Health. 2003 Sep;80(3):455-64
Publication Type
Article
Date
Sep-2003
Author
Evan Wood
Thomas Kerr
Patricia M Spittal
William Small
Mark W Tyndall
Michael V O'Shaughnessy
Martin T Schechter
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada. BC V6Z 1Y6. ewood@hivnet.ubc.ca
Source
J Urban Health. 2003 Sep;80(3):455-64
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Female
HIV Infections - prevention & control - transmission
Humans
Male
Middle Aged
Needle Sharing - adverse effects
Needle-Exchange Programs - organization & administration
Peer Group
Program Evaluation
Prospective Studies
Questionnaires
Risk Reduction Behavior
Risk-Taking
Substance Abuse, Intravenous - virology
Syringes - utilization
Abstract
In Vancouver, British Columbia, Canada, difficulty accessing syringes at night has been shown to be strongly associated with human immunodeficiency virus (HIV) risk behavior among the city's injection drug users (IDUs). On September 1, 2001, the Vancouver Area Network of Drug Users (VANDU) initiated an unsanctioned all-night needle-exchange program on a street corner in the heart of the neighborhood where many of the city's IDUs are concentrated. An external evaluation of the population reached by the VANDU exchange was performed through the Vancouver Injection Drug User's Study, a prospective cohort study of IDUs begun in 1996. Persons accessing syringes through the exchange were compared to those active injectors who acquired their syringes from other sources, including the city's fixed site exchange, which closes at 8:00 PM. Overall, 587 active IDUs were seen during the period September 2001 to June 2002; of these individuals, 165 (28.1%) reported using the VANDU exchange. In multivariate analyses, participants who used the VANDU table were more likely to frequently inject cocaine (adjusted odds ratio [AOR]=1.56; 95% confidence interval [CI]=1.00-2.44), inject in public (AOR=2.71; 95% CI=1.62-4.53), and require help injecting (OR=2.13; 95% CI=1.33-3.42). Interestingly, use of the table was also independently associated with safer syringe disposal (AOR=2.69; 95% CI=1.38-5.21). Results indicate that the unsanctioned exchange appears to have reached those IDUs at highest risk of HIV infection. Although the cross-sectional nature of the study design warrants caution, we also found that use of the nighttime exchange was strongly associated with higher rates of safe syringe disposal. The data suggest that drug user organizations can play a major role in reducing harm among their peers by reaching the highest risk drug users with harm reduction services. The findings also suggest that other forms of syringe-exchange programs should consider the benefits of offering fixed site nighttime service.
Notes
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PubMed ID
12930883 View in PubMed
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An integrated supervised injecting program within a care facility for HIV-positive individuals: a qualitative evaluation.

https://arctichealth.org/en/permalink/ahliterature150952
Source
AIDS Care. 2009 May;21(5):638-44
Publication Type
Article
Date
May-2009
Author
Andrea Krüsi
Will Small
Evan Wood
Thomas Kerr
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
Source
AIDS Care. 2009 May;21(5):638-44
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Delivery of Health Care - organization & administration
Drug Users - education
Female
HIV Infections - drug therapy
Humans
Male
Middle Aged
Needle-Exchange Programs - organization & administration
Patient satisfaction
Substance Abuse Treatment Centers - organization & administration
Substance Abuse, Intravenous - drug therapy - epidemiology
Abstract
While there has been growing interest in comprehensive models of treatment and care for individuals living with HIV/AIDS, little attention has been given to the potential role that supervised injecting programs could play in increasing access to prevention and care services for HIV-positive injection drug users (IDU). We conducted 22 semi-structured interviews with HIV-positive IDU regarding a supervised injection program integrated in an HIV focused care facility known as the Dr. Peter Centre (DPC). We also interviewed seven staff members who supervise injections within the facility. All interviews were audio recorded, transcribed verbatim, and a thematic analysis was conducted. Participant and staff reports indicated that the integrated supervised injection program influenced IDUs' access to care by building more open and trusting relationships with staff, facilitating engagement in safer injection education and improving the management of injection-related infections. Participants and staff viewed the program as facilitating the delivery of care through mediating overdose risks, reducing the need to punitively manage drug use on-site and reducing the risks of encountering used syringes on the premises. For some participants, however, feelings of shame and fear of judgment in relation to their drug use limited initial uptake of the program. Our findings identify mechanisms through which integrated supervised injection programs may serve to better facilitate access and delivery of comprehensive care for HIV-positive IDU and highlight the benefits of addressing HIV-positive IDUs' drug use in the context of comprehensive models of healthcare.
PubMed ID
19444673 View in PubMed
Less detail

Antiretroviral adherence and HIV treatment outcomes among HIV/HCV co-infected injection drug users: the role of methadone maintenance therapy.

https://arctichealth.org/en/permalink/ahliterature170216
Source
Drug Alcohol Depend. 2006 Sep 15;84(2):188-94
Publication Type
Article
Date
Sep-15-2006
Author
Anita Palepu
Mark W Tyndall
Ruth Joy
Thomas Kerr
Evan Wood
Natasha Press
Robert S Hogg
Julio S G Montaner
Author Affiliation
Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, BC, Canada. anita@hivnet.ubc.ca
Source
Drug Alcohol Depend. 2006 Sep 15;84(2):188-94
Date
Sep-15-2006
Language
English
Publication Type
Article
Keywords
Adult
Anti-Retroviral Agents - blood - therapeutic use
British Columbia - epidemiology
Cohort Studies
Comorbidity
Demography
Female
Follow-Up Studies
HIV Infections - drug therapy - epidemiology
Hepatitis C - epidemiology
Humans
Male
Methadone - therapeutic use
Narcotics - therapeutic use
Patient Compliance - statistics & numerical data
Prevalence
Questionnaires
Risk-Taking
Substance Abuse, Intravenous - epidemiology - rehabilitation
Abstract
We examined the association of methadone maintenance therapy (MMT) with highly active antiretroviral therapy (HAART) adherence and HIV treatment outcomes among a cohort of HIV/HCV co-infected injection drug users (IDUs).
We obtained demographic, drug use, and addiction care history from the Vancouver Injection Drug User Study (VIDUS), which is an open cohort study of IDUs. The questionnaires were longitudinally linked to the British Columbia HIV/AIDS Drug Treatment Program to obtain HAART adherence and HIV treatment outcome data. There were 278 VIDUS participants who accessed HAART from August 1, 1996 to November 24, 2003. We constructed longitudinal logistic models using generalized estimating equations to examine the independent associations between methadone maintenance therapy and the following outcomes: HAART adherence; plasma HIV-1 RNA suppression; and CD4 cell rise of 100cells/mm(3).
Among participants who reported at least weekly heroin use, MMT was independently associated with lower odds of subsequent weekly heroin use during the follow-up period (adjusted odds ratio; 95% confidence interval [AOR; 95% CI]: 0.24; 0.14-0.40). We also found that MMT was positively associated with adherence (AOR 1.52; 95% CI 1.16-2.00), HIV-1 RNA suppression (AOR 1.34; 95% CI 1.00-1.79), and CD4 cell count rise (AOR 1.58; 95% CI 1.26-1.99).
Among HIV/HCV co-infected IDUs on HAART, enrollment in MMT was associated with reduced heroin use, and improved adherence, HIV-1 RNA suppression and CD4 cell count response. Integrating opiate addiction care and HIV care may provide improved health outcomes for this vulnerable population and should be further explored.
PubMed ID
16542797 View in PubMed
Less detail

Assessing the impact of an adult day program on hospital utilization by persons living with HIV/AIDS.

https://arctichealth.org/en/permalink/ahliterature188388
Source
J Acquir Immune Defic Syndr. 2002 Sep 1;31(1):117-9
Publication Type
Article
Date
Sep-1-2002

206 records – page 1 of 21.